U.S. patent application number 10/958179 was filed with the patent office on 2005-04-07 for ct imaging system for robotic intervention.
Invention is credited to Clinthomc, Neal, Sukovic, Predrag.
Application Number | 20050075563 10/958179 |
Document ID | / |
Family ID | 34434918 |
Filed Date | 2005-04-07 |
United States Patent
Application |
20050075563 |
Kind Code |
A1 |
Sukovic, Predrag ; et
al. |
April 7, 2005 |
CT imaging system for robotic intervention
Abstract
The present invention is an image-guided robotic surgical system
including a CT scanning system. The CT scanning system first
performs a low-dose scan of a general area of interest of the
patient's body and an image is generated on a display. Using the
image a region-of-interest, within the patient's body is defined.
Limited field-of-view scans are used to update the
region-of-interest image while data gathered during the initial
scan is used for area outside the region-of interest.
Inventors: |
Sukovic, Predrag; (Ann
Arbor, MI) ; Clinthomc, Neal; (Ann Arbor,
MI) |
Correspondence
Address: |
CARLSON, GASKEY & OLDS, P.C.
400 WEST MAPLE ROAD
SUITE 350
BIRMINGHAM
MI
48009
US
|
Family ID: |
34434918 |
Appl. No.: |
10/958179 |
Filed: |
October 4, 2004 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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60508517 |
Oct 3, 2003 |
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Current U.S.
Class: |
600/427 |
Current CPC
Class: |
G16H 50/50 20180101;
A61B 6/469 20130101; A61B 6/4441 20130101; A61M 5/1452 20130101;
A61B 6/12 20130101 |
Class at
Publication: |
600/427 |
International
Class: |
A61B 005/05 |
Claims
What is claimed is:
1. A computer guided surgical system comprising: a needle
insertable into a region of interest in a patient; a X-ray source
and detector rotatable about an axis; a controller connected to the
X-ray source and detector in order to control scanning of the
region of interest of the patient, the region of interest contained
within a general area of the patient, the controller generating an
updated 3D model of the region of interest and the needle based
upon the scanning of the region of interest; and a display
connected to said controller to provide an updated image of the
needle within the region of interest.
2. The computer guided surgical system of claim 1, wherein said
display is continuously updated by repeatedly scanning the region
of interest.
3. The computer guided surgical system of claim 1, wherein said
controller controls movement of the needle within the region of
interest.
4. The computer guided surgical system of claim 1, wherein the
controller generates the updated 3D model of the region of interest
based upon the scanning of the region of interest and based upon
information regarding the general area of the patient surrounding
the region of interest.
5. The computer guided surgical system of claim 4, wherein said
X-ray source is a cone-beam X-ray source.
6. The computer guided surgical system of claim 1, wherein the
information regarding the general area of the patient is a scan of
the general area of the patient at a dosage lower than the scanning
of the region of interest.
7. The computer guided surgical system of claim 1, wherein said
controller includes a CPU and computer input device.
8. A method of computer guided surgery comprising: a) storing first
image information regarding a general area of a patient; b)
selecting an region of interest within the general area; c)
scanning the region of interest; d) creating a three dimensional
image of the region of interest based upon the first image
information and based upon said step c); and e) guiding a needle
within the region of interest based upon the three dimensional
image.
9. The method of claim 8, wherein said step a) further includes
using a low dose scan of the general area of the patient to collect
data for the first image information.
10. The method of claim 9, wherein said step c) further includes
using a higher dosage scan than used for said step a).
11. The method of claim 8, wherein said step c) further includes
using a conical shaped X-ray beam to scan the region of
interest.
12. The method of claim 11, wherein a smaller diameter beam is used
in said step c) than in said step a).
13. The method of claim 8, further including repeating steps c-d)
during said step e), such that the guiding in said step e) is based
upon an updated three dimensional image.
14. A computer guided surgical system comprising: an X-ray source
and detector mounted to a c-arm; a carriage supporting said c-arm
such that said c-arm can rotate about an axis at a center of said
c-arm; a pair of rails supporting said c-arm and carriage such that
said c-arm and carriage can translate along said axis a controller
connected to the X-ray source, detector, and c-arm in order to scan
an object, wherein said controller controls a needle within a
region of interest in the object, the controller generating a
three-dimensional image of the object based upon a general area
scan of the object and based upon repeated scans of a region of
interest in the object, the region of interest disposed within the
general area; and a display connected to said controller to provide
an updated image of said object based upon the general area scan
and the region of interest scans.
15. The computer guided surgical system of claim 14, wherein the
region of interest is defined based upon the movement of the
needle.
Description
BACKGROUND OF THE INVENTION
[0001] For certain surgical treatments, the precise location of an
instrument, such as a probe or needle, within a patient's body is
critical. For example, particular medicines can be delivered via a
needle to a precise location within the body. One such application
is the delivery of an anti-cancer drug to the exact location of the
tumor.
[0002] Doctors have used fluoroscopy to track the position of the
needle into the body as it is inserted to the desired location.
However, fluoroscopy only provides the doctors with a
two-dimensional view of the needle's position in the body. As a
result, it has been proposed to use a computed tomography scanner
in order to provide a three-dimensional view of the position of the
needle as the doctor inserts it into the body. The CT scanner
operates continuously in order to provide an up-to-date
three-dimensional view of the needle's position.
[0003] However, both the fluoroscopy and the CT scanner expose the
doctor and the patient to radiation. Therefore, it has also been
proposed to use robots, remotely controlled by the surgeon watching
the CT image, to insert the needle into the patient's body. In
these systems, the CT scanner includes an x-ray source and an x-ray
detector on opposite sides of the patient's body near the needle.
The x-ray from the x-ray source is collimated to emit a fan-beam
x-ray producing a plurality of "slices" through the patient's body
as the x-ray source and detector revolve around the patient's body.
The doctor views the three-dimensional image while remotely
controlling the needle's position in the patient's body. In this
manner, the doctor can avoid the unnecessary doses of
radiation.
[0004] This proposed CT system has some drawbacks. First, because
the x-ray source is a fan-beam x-ray source, imaging only a narrow
slice at a time, it is difficult to keep the tip of the needle in
the field of view. This is particularly true when the needle is
traveling generally parallel to the axis of rotation of the CT
scanner. The CT scanner is fixed in the room, so the patient bed,
the patient and the robot must be translated along the axis of
rotation of the CT scanner to keep the needle tip in the field of
view. Additionally, although the doctor can avoid excessive doses
of radiation by using the robot, the continuous scanning by the CT
scanner exposes the patient's body to more radiation than
necessary.
SUMMARY OF THE INVENTION
[0005] The present invention is an image-guided surgical system
including a CT scanning system, for example, for use with robotic
intervention.
[0006] The CT scanning system includes a source and detector
mounted to a c-arm positioned on a carriage, such that the c-arm
can be rotated about an axis centered within the c-arm. The
carriage is also slidably mounted on rails such that the carriage
and c-arm can translate along the axis. The system further includes
a surgical robot for inserting a needle into a patient's body.
[0007] A controller controls the source, detector, surgical robot,
and any hardware for moving the c-arm. The controller may be a CPU
including a display and an input device. The CPU gathers the data
and images from the detector and generates a three-dimensional
image. The controller and the doctor controlling the system would
be in a location that is shielded from radiation of the x-ray
source.
[0008] The CT scanning system first scans a low-dose scan of the
general area of interest of the patient's body and a
three-dimensional model or image is generated by the CPU. Using the
image and an input device, the doctor defines a region-of-interest,
within the patient's body. Once the region-of-interest is defined,
the source and detector are then activated to produce a plurality
of images of the region-of-interest.
[0009] If it is assumed that the areas of the patient's body
outside the region-of-interest are not going to change during the
procedure, then it is sufficient to use the data gathered during
the initial, low-dose scan for the areas of the patient's body
surrounding the region-of-interest, to update the original model.
Only limited field-of-view scans are needed to update the
region-of-interest image. Additionally, the x-ray source is a
cone-beam x-ray source to easier to keep the needle within the
image during the region-of-interest scan. Thus, the patient's body
receives a lower dose of radiation than would otherwise be
applied.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] The above, as well as other advantages of the present
invention, will become readily apparent to those skilled in the art
from the following detailed description of a preferred embodiment
when considered in the light of the accompanying drawing in
which:
[0011] FIG. 1 is a schematic of the surgical and CT scanning system
of the present invention;
[0012] FIG. 2 illustrates an end view of the surgical and CT
scanning system;
[0013] FIG. 3 illustrates an initial low dose scan of a general
area; and
[0014] FIG. 4 illustrates a high dose region of interest scan.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0015] FIGS. 1 and 2 shows an image-guided robotic surgical system
20 including a CT scanning system 21. The CT scanning system 21
includes a source 22 and detector 24 mounted at outer ends of a
c-arm 30. The source 22 is preferably a cone-beam x-ray source 22.
The c-arm 30 is also preferably slidably mounted on a carriage 32,
such that the c-arm 30 can be rotated about an axis x,
substantially centered within the c-arm 30 and positioned
substantially between the source 22 and detector 24. The carriage
32 is also slidably mounted on rails 36 such that the carriage 32
and c-arm 30 can translate along the x-axis. The carriage 32 and/or
the rails 36 may be part of (or simply placed below) a radiolucent
operating table 38.
[0016] The system 20 further includes a surgical robot 40 for
inserting a needle 42 into a patient's body 44 and delivering a
drug at a precisely determined location in the patient's body 44
through the needle 42. The robot 40, or a portion of the robot 40,
may optionally include a plurality of locators 46. The position of
each of the locators 46 is tracked by a tracking system 48 to
determine the position and orientation of the robot 40 and needle
42. Suitable tracking systems 48 and locators 46 are known in the
field of image-guided surgery. The locators 46 and tracking system
48 are not necessary in the present invention, because the
three-dimensional position and orientation of the needle 42
relative to the patient's body 44 is tracked with the CT scanner,
but may further aid in the placement of the needle 42 and/or the
control of the robot 40.
[0017] The source 22, detector 24, surgical robot 40 (FIG. 1),
tracking system 48 (if used), and any motors and controllers for
rotating and translating the c-arm 30 are all controlled by a
controller, which may be a CPU 50. The CPU 50 includes a display 52
and an input device 54, such as a mouse, keyboard, joystick, etc.
The CPU 50 also gathers the data and images from the detector 24
and generates three-dimensional images based upon the data and
images from the detector 24. The CPU 50, including display 52,
input device 54, and the doctor controlling the system 20 via input
device 54, would be in a location that is shielded from radiation
of the x-ray source 22.
[0018] Referring also to FIG. 3, a low-dose scan of the general
area of interest of the patient's body 44 (or the entire body 44)
is first scanned by the CT scanning system 21 and a
three-dimensional model or image is generated by the CPU 50 and
displayed on the display 52. While viewing the image on the display
52 and by using the input device 54, the doctor defines a
three-dimensional region-of-interest 60, such as a sphere, within
the patient's body 44. For example, it is anticipated for the
particular application of inserting a needle for drug delivery that
the region-of-interest 60 would be on the order of a few inches in
diameter.
[0019] Once the region-of-interest 60 is defined, the source 32 and
detector 24 are then activated to produce a plurality of images of
the region-of-interest 60 of the patient's body. The c-arm 30 is
rotated about the x-axis by computer-controlled motors in the
carriage 32 as the source 22 and detector 34 take images sufficient
to update the three-dimensional image of the region-of-interest 60
of the patient's body. The doctor initiates the insertion of the
needle 42 by the robot 40 into the patient's body 44 toward the
region-of-interest 60. Within the region-of-interest 60, the doctor
controls the insertion of the needle 42 while watching the display
52 continuously update the three-dimensional displayed position and
orientation of the needle 42 within the body 44. During the
procedure, the doctor can rotate, enlarge or otherwise manipulate
the image on the display 52, so that the doctor can monitor,
control and adjust the travel of the needle 42 into the body
44.
[0020] Referring to FIG. 4, since the CPU 50 has already stored
data relating to the areas of the patient's body 44 surrounding the
region-of-interest 60, the CPU 50 can update the original model of
the region-of-interest 60 based upon the data from the initial,
full scan and based upon the limited field-of-view scan of just the
region-of-interest 60. As can be seen in FIG. 4, the cone beam
x-ray from the x-ray source 22 is narrowed substantially, such that
it does not pass through the entire portion of the patient's body,
but is focused only on the region-of-interest 60. It is assumed
that the areas of the patient's body outside the region-of-interest
60 are not going to change during the procedure, so it is
sufficient to simply use the data gathered during the single,
initial, low-dose full scan (FIG. 3). Thus, the patient's body 44
receives a lower dose of radiation than would otherwise be applied.
Additionally, because the x-ray source 22 is a cone-beam x-ray
source 22, it is easier to keep the needle 42 within the
region-of-interest 60 during the procedure. When the needle 42 has
reached the desired location, the doctor controls the robot 40 to
deliver the drug and then retract out of the patient's body 44.
Alternatively, information regarding the areas of the patient's
body outside the region of interest 60 may be generic--i.e.
predetermined and pre-stored and not specifically from the
particular patient for which it is used.
[0021] The CT scanning system 21 of the present invention could
also be used without the robot 40. The doctor could manually insert
the needle 42 (or probe) into the patient's body 44 while
monitoring the position and orientation of the needle 42 on the
display 52 to ensure that the needle 42 is inserted into precisely
the desired location within the patient's body 44.
[0022] Alternatively, or as an addition to the updates performed by
the CT scanning system (i.e. between CT updates), the locators 46
and tracking system 48 may be used to track the position of the
needle 42 relative to the 3-dimensional image of the patient's body
44 created from a CT scan. Similarly, sensors and motors in the
robot 40 could provide the information regarding the position of
the needle 42 relative to the 3-dimensional image as the needle 42
is inserted.
[0023] Although a preferred embodiment of this invention has been
disclosed, a worker of ordinary skill in this art would recognize
that certain modifications would come within the scope of this
invention. For that reason, the following claims should be studied
to determine the true scope and content of this invention.
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